title: Coxsackie B3 myocarditis in a case of sudden unexpected death in young athlete: histopathological, immunohistochemical and molecularpathological for diagnosis.
abstract: Virus-induced myocarditis is a common disease even in infants and young adults, but the diagnosis can be difficult according to the Dallas-criteria, which have been criticized as being too unreliable. The diagnosis has been substantially improved due to immunohistochemistry (IHC) for the detection of the VP1-capsid-protein of enterovirus as well as reversetranscriptase-polymerase chain reaction assays (RT-PCR) for viral genome detection. We report an unusual case of myocarditis in a young adult athlete whose heart disease was not clinically recognized and, thus, caused his sudden unexpected death (SUD). Histopathological investigations of heart tissue samples revealed signs of myocarditis. IHC was used to detect the VP1-capsid-protein of enterovirus. RT-PCR assays were used to detect enterovirus RNA. Enterovirus myocarditis was determined as a cause of death.
authors.affiliation: Laboratory of Transmissible Diseases LR99-ES27, Faculty of Pharmacy, Monastir, Tunisia. chbeli_imed@yahoo.fr
authors.forename: Imed
authors.initials: I
authors.lastname: Gaaloul
authors.forename: Samira
authors.initials: S
authors.lastname: Riabi
authors.forename: Rafik
authors.initials: R
authors.lastname: Harrath
authors.forename: Mark
authors.initials: M
authors.lastname: Evans
authors.forename: Sally
authors.initials: S
authors.lastname: Huber
authors.forename: Mahjoub
authors.initials: M
authors.lastname: Aouni
mesh_terms: D000328:Adult; D056352:Athletes; D036022:Capsid Proteins / Q000032:analysis; D003645:Death, Sudden / Q000209:etiology*; D029822:Enterovirus B, Human / Q000235:genetics; D004769:Enterovirus Infections / Q000175:diagnosis*; D049429:Forensic Pathology; D006346:Heart Septum / Q000473:pathology / Q000821:virology; D006352:Heart Ventricles / Q000473:pathology / Q000821:virology; D006801:Humans; D007150:Immunohistochemistry; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000821:virology*; D009206:Myocardium / Q000473:pathology; D009336:Necrosis / Q000473:pathology; D012367:RNA, Viral / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014416:Tunisia; D055815:Young Adult
chemical_list: D036022:Capsid Proteins; D012367:RNA, Viral